FFP Utilization Status in Cardiac Surgery Patients

Background and Objectives: Cardiac surgery is a major risk for excessive perioperative bleeding due to several causes such as iatrogenic vascular injury, hemostatic defects and reduced platelet function as consequences of cardiopulmonary bypass(CPB), and preoperative antiplatelet drug therapy, which all may lead to surgical re-exploration. FFP is commonly used as a prophylactic or therapeutic measure in these settings. Diversity in FFP utilization pattern indicates a lack in general agreement on indications and triggers for its prescription in clinical conditions. This study was designed to assess ongoing FFP utilization status in cardiac surgery patients.Methods: This cross-sectional descriptive study was conducted to evaluate FFP usage status in cardiac surgery patients in Sanandaj Tohid hospital during 2014. Data regarding patients’ demographic Information such as age and sex, extra corporeal circulation implementation(off-pump v/s on pump surgery), pre-operative lab tests, number of transfused FFP units and the ward in which FFP was transfused(operation room, ICU, post cardiac surgery ward) ,were collected for all patients undergoing CABG during the study period. SPSS 16 Chicago was applied for data analysis. Results are presented as frequency, mean, and standard deviations. T-student, One Way Anova, and χ 2 exam were organized matching mean deviation, variance analysis, and ratio comparison respectively. P values ≤0.05 were considered statistically significant. Results: 96 patients were operated by isolated CABG(with no other associated procedure) at 2014 ,33(34%) women and 63(66%) men with mean age of 62.88±10.69 years. Among these, 91(94.8%) were operated off-pump and the remaining 5(5.2%) underwent on pump surgery. Mean FFP utilization in all CABG patients in all locations was obtained as 1.96±2.99 units(P=0.01) generally . Accordingly, mean FFP usage in all off-pump and all on-pump patients were 1.7±2.63 and 4.93±6.47, with mean PT and PTT levels of 13.02±1.97 and 40.5±17.9 respectively. FFP utilization in operation room was 0.88±1.97 units in off-pump and 1.43±2.10 units in on pump patients. Also FFP utilization was 0.82±2.00 units in off-pump and 3.14±5.37 units in on pump patients in ICU, and 0.02±0.21 units in off-pump and 0.14±0.53 units in on pump patients in post cardiac surgery ward.Conclusion: Our study revealed that FFP utilization was higher in on-pump v/s off-pump CABG patients, this usage was highest in Intensive Care Unit(ICU) and that the level of PT and PTT could not predict FFP transfusion. Further studies with larger study groups(specifically on-pump patients) is suggested for more reputable results.

کلیدواژه ها:

CABG ، Off-pump ، on-pump ، FFP.